ABSTRACT
Objetivos: Actualizar el nomenclátor de actos médicos de la especialidad de Neurocirugía, eliminando actos en desuso y añadiendo las nuevas técnicas quirúrgicas desarrolladas en los últimos años, para que se adapte fielmente a la práctica médica habitual de nuestra especialidad, así como establecer los principios generales y definir los criterios de baremación, indicadores cuantitativos y escalas de valoración. Material y método: La elaboración del nuevo nomenclátor se dividió en 3 fases: 1) identificación y selección de los actos médicos, 2) establecimiento del grado de dificultad de cada uno de ellos basado en la experiencia y el tiempo necesarios para su realización, así como el porcentaje y gravedad de las posibles complicaciones y 3) consenso con los miembros de la SENEC mediante su envío individualizado, realizando los retoques necesarios y posterior aprobación en asamblea de la especialidad. Resultados: El nuevo nomenclátor cuenta con 255 actos médicos agrupados en 4 grupos: consultas y visitas, actos terapéuticos, procedimientos diagnósticos e intervenciones quirúrgicas. Se han eliminado 42 procedimientos recogidos en el nomenclátor de la OMC por obsoletos, no ser propios de la especialidad o resultar demasiado vagos. Se han introducido nuevas técnicas y se han definido de forma más precisa los actos médicos. Conclusiones: Este nomenclátor proporciona una terminología actualizada y servirá para ofertar la cartera de servicios, medir y conocer el valor relativo de nuestra actividad y de los costes aproximados de los procedimientos, y adicionalmente, para realizar estudios comparativos longitudinales. Debe constituir una herramienta para mejorar la atención de los pacientes y minimizar la variabilidad geográfica en todos los ámbitos asistenciales.(AU)
Purpose: Update the list of medical acts in the specialty of neurosurgery, eliminating obsolete acts and adding the new surgical techniques developed in recent years, so that they are faithfully adapted to the usual medical practice of our specialty, as well as establishing the general principles and defining the grading criteria, quantitative indicators and assessment scales. Material and method: The elaboration of the new nomenclator was divided into three phases: (1) identification and selection of medical acts, (2) establishment of the degree of difficulty of each of them based on the experience and the time necessary for their completion, as well as the percentage and severity of the possible complications and (3) consensus with the members of the SENEC through their individualized submission, making the necessary adjustments and subsequent approval in the general assembly of SENEC. Results: The new nomenclator has 255 medical acts grouped into four groups: consultations and visits, therapeutic acts, diagnostic procedures and surgical interventions. Forty-two procedures included in the OMC nomenclator have been eliminated due to being obsolete, not related to the specialty or being too vague. New techniques have been included and medical acts have been more precisely defined. Conclusions: This nomenclator provides up-to-date terminology and will serve to offer the portfolio of services, measure and know the relative value of our activity and the approximate costs of the procedures, and additionally, to carry out longitudinal comparative studies. It should be a tool to improve patient care and minimize geographic variability in all healthcare settings.(AU)
Subject(s)
Humans , Male , Female , Neurosurgery , Neurosurgical Procedures , Terminology as TopicABSTRACT
The rapid evolution of new SARS-CoV-2 variants poses a continuing threat to human health. Vaccination has become the primary therapeutic intervention. The goal of the current work was the construction of immunogenic virus-like particles (VLPs). Here, we describe a human cell line for cost-efficient and scalable production of immunogenic SARS-CoV-2 VLPs. The modular design of the VLP-production platform facilitates rapid adaptation to new variants. Methods: The N, M-, and E-protein genes were integrated into the genome of Expi293 cells (ExpiVLP_MEN). Subsequently, this cell line was further modified for the constitutive expression of the SARS-CoV-2 spike protein. The resulting cell line (ExpiVLP_SMEN) released SARS-CoV-2 VLP upon exposure to doxycycline. ExpiVLP_SMEN cells were readily adapted for VLP production in a 5 L bioreactor. Purified VLPs were quantified by Western blot, ELISA, and nanoparticle tracking analysis and visualized by electron microscopy. Immunogenicity was tested in mice. Results: The generated VLPs contained all four structural proteins, are within the size range of authentic SARS-CoV-2 virus particles, and reacted strongly and specifically with immunoserum from naturally infected individuals. The VLPs were stable in suspension at 4 °C for at least 10 weeks. Mice immunized with VLPs developed neutralizing antibodies against lentiviruses pseudotyped with the SARS-CoV-2 spike protein. The flexibility of the VLP-production platform was demonstrated by the rapid switch of the spike protein to a new variant of concern (BA.1/Omicron). The present study describes an efficient, scalable, and adaptable production method of immunogenic SARS-CoV-2 VLPs with therapeutic potential.
ABSTRACT
BACKGROUND: Liposarcoma (LPS) is a rare type of tumor; they come from the adipose tissue. It is the most common type of soft-tissue sarcoma. Every type of LPS has morphological features, immunophenotypic, and molecular pathogenesis characteristics of their own. In this case, we are going to report a cerebellar metastatic disease from a well-differentiated liposarcoma (WDL) with pleomorphic component, not found in our literature research. CASE DESCRIPTION: A 72-year-old woman with progressive pain and inflammation in the left knee with functional limitation when climbing stairs. MRI shows a tumor in the vastus medialis of the left thigh. Pathology result was pleomorphic and WDL, Stage III and negative for MDM2 and CDK4. Extension study was carried out, finding nodular lesion in the right cerebellar hemisphere with mass effect and partial obliteration of the fourth ventricle, suspicious of distant disease. CONCLUSION: Cerebellar metastasis of LPS is uncommon; there are only a few cases reports with the literature reviews describing orbital or skull base metastases, but not in the cerebellum. Our case allows us to remember that neurological symptoms, no matter how subtle, in patients diagnosed with LPS, a secondary affectation of the central nervous system must be ruled out, even though it is a rare location. The findings of distant disease in LPSs, allow planning oncological treatment options and targeted radiotherapeutic.
ABSTRACT
Even though much progress has been made towards understanding the molecular nature of glioma, the survival rates of patients affected by this tumour have not changed significantly over recent years. Better knowledge of this malignancy is still needed in order to predict its outcome and improve patient treatment. VAV1 is an GDP/GTP exchange factor for Rho/Rac proteins with oncogenic potential that is involved in the regulation of cytoskeletal dynamics and cell migration. Here we report its overexpression in 59 patients diagnosed with high-grade glioma, and the associated upregulation of a number of genes coding for proteins also involved in cell invasion- and migration-related processes. Unexpectedly, immunohistochemical experiments revealed that VAV1 is not expressed in glioma cells. Instead, VAV1 is found in non-tumoural astrocyte-like cells that are located either peritumouraly or perivascularly. We propose that the expression of VAV1 is linked to synergistic signalling cross-talk between cancer and infiltrating cells. Interestingly, we show that the pattern of expression of VAV1 could have a role in the neoplastic process in glioblastoma tumours.
